2017_SBRT_Course Book
Region at highest risk: epidural space
1 Fx 3 Fx 5 Fx 10 Fx 20 Fx
Spinal cord tolerance
10Gy
18Gy
23Gy
35Gy
45Gy
Epidural tumor [EQD2] 17Gy 24Gy 29Gy 39Gy 46Gy Implications for target volume definition / fractionation: Ø More fractionated RT for cases with epidural involvement
/ ESTRO SBRT 2017 - Matthias Guckenberger
07.09.17
29
IMRT versus VMAT for spine SBRT
VMAT
Step-and-shoot IMRT
Delivery time: 3.5 min vs 10.5 min
Plan quality: No difference
Lee BJR 2013 • Substantially shorter delivery times • Comparable dosimetric plan quality Ø VMAT preferable for patients in pain
ESTRO SBRT 2017 - Matthias Guckenberger
07.09.17
30
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